The information provided on this page is intended for general educational and informational use only. It is not specific, personalized healthcare advice for you. For healthcare advice regarding your particular situation, talk to members of your healthcare team.

The Question

A 43-year-old woman came to the pharmacy looking for relief from her cold symptoms. She reported feeling stuffy, having a headache, and using lots of Kleenex. It all started yesterday, and she has no other symptoms. She also takes medicine for high cholesterol and high blood pressure.

She asks, "What is safe to take if I have high blood pressure?"

Decongestants Will Raise Blood Pressure

The Short Answer

When people are looking for medicine for their cold, they usually want a decongestant. Decongestants relieve pressure in the sinuses, which in turn resolve some of the other cold symptoms, including headache, sore throat, and coughing. Unfortunately, just by their nature, decongestants also raise blood pressure. In general, people with high blood pressure should not use decongestants. However, if you are careful, small doses for short periods may be ok.

The Long Answer

Decongestants, such as pseudoephedrine (Sudafed), are wonderful drugs that can make a severe cold bearable. They work by constricting blood vessels that would otherwise deliver too much fluid to the sinuses. Unfortunately, this effect also results in a rise in blood pressure.

For people who don't have high blood pressure:

The increase probably won't even be noticed. You may still feel it a bit—by way of an increased heart rate or mild anxiety—but it isn't dangerous. Enjoy your decongestant!

For people who have high blood pressure that is not well-controlled:

You should avoid decongestants. The increase could be dangerous. Whether you are taking high blood pressure medication that isn't working well enough, or you aren't taking medicine at all, if your blood pressure is currently too high, you should look for alternatives. The blood vessel constriction could put too much strain on your heart, putting you at risk for heart attacks, stroke, or other complications. If you're not sure if your blood pressure is okay, your pharmacist can measure it for you.

For people who have high blood pressure that is well-controlled:

Whether it is controlled by diet and exercise or by medication, a short therapy of mild decongestants would be okay. You can still expect the blood pressure increase, but it won't be dangerous. Limit decongestant use to 3 to 5 days, and have your pharmacist help you find a mild decongestant.

Cold Remedies and High Blood Pressure

Medicine

What does it do?

Is it safe with high blood pressure?

Nasal decongestant

The same thing as Sudafed, but acts locally in the nose.

Safer, since it stays in the sinuses. It can only be used for 5 days, and can still raise blood pressure.

Air humidifier

Breaks up mucus with moist air.

Completely safe.

Nasal strips

Opens up airways to make breathing easier.

Completely safe.

Cough syrup

Stops a cough

Yup.

Acetaminophen

Stops a headache

Of course.

As far as treating congestion goes, decongestants are the obvious choice. There are some other medicines that can help (see above), but they won't be quite as powerful. But when you have high blood pressure, safety is most important.

You can treat other symptoms of a cold with targeted medications. Talk to your pharmacist and explain exactly what you want to treat. They can help you find what's best for your situation. Remember to tell them if you have any pre-existing conditions.

There is a brand of cold medications targeted to people with high blood pressure called Coricidin. They have a number of products that are all decongestant-free. They usually have a combination of ingredients, so it's important to have your pharmacist help you choose one that has everything you need and nothing you don't.

A Bit More on the Topic

There are so many of over-the-counter medicines available today. When you consider the hundreds of medications and dozens of common health conditions, it's no surprise that there is a high potential for interactions, be it drug-drug, drug-condition, etc.

When you have a health condition, it's important to know what medications can put you at higher risk for these interactions. There are a lot of medications you should avoid. Your pharmacist is a valuable resource in using medication safely.

When selecting over-the-counter medicine for self-treatment, always:

Read the entire label.

Ask questions.

Know your own health conditions and what to look for on the box.

Ask questions.

Stick with products that have worked safely in the past.

Ask questions.

The Final Word

Decongestants like Sudafed will raise your blood pressure. Whether this is dangerous for you, personally, depends on whether you have high blood pressure and whether it's controlled. There are other cold medicines you can use that won't raise your blood pressure. Your pharmacist is a valuable resource for finding the right over-the-counter product for you.

Have you asked your pharmacist about cold medicine interactions before?

Ask a Pharmacist

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Author

Brandon Young 2 years agofrom Minnestoa

If the active ingredient is phenylephrine, then you probably can. Phenylephrine is an older decongestant that is "weaker" than the typical pseudoephedrine found in regular Suadfed. It also does not have the same side effects. For someone who has well controlled high blood pressure, 3 to 5 days of phenylephrine is generally considered OK.

Bea Smith 2 years ago

I have high blood pressure but I take two different kinds of blood pressure medicines to lower it; will I be able to use the new Sudafed with the heart on the box?